Coumadin is used for treating and preventing harmful clots that may occur in the veins (venous thrombosis), in the lungs (pulmonary embolism), with a type of abnormal heartbeat (atrial fibrillation), or following a heart valve replacement.

Coumadin is used for treating and preventing harmful clots that may occur in the veins (venous thrombosis), in the lungs (pulmonary embolism), with a type of abnormal heartbeat (atrial fibrillation), or following a heart valve replacement. Coumadin is also used to reduce the risk of stroke and other problems in patients who have had a heart attack. Coumadin is an anticoagulant. It works by blocking the synthesis of certain clotting factors. Without these clotting factors, blood clots are unable to form.

INSTRUCTIONS

Use Coumadin as directed by your doctor.

Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Never take a double dose of this medication or take it together with other products that contain warfarin or coumarin.

Your doctor may occasionally change your dose to make sure you get the best results.

Take Coumadin at the same time every day. Coumadin can be taken with or without food.

if you have a history of liver, kidney, or thyroid problems; yellowing of the skin or eyes; mental or mood problems; high cholesterol; arthritis; diabetes; or cancer

if you have poor nutrition, celiac disease, nutrient or fat absorption problems, or low levels of vitamin K or vitamin C in the blood, or if you drink alcohol

if you have a fever, very poor health, diarrhea, fluid buildup, excessive fat in the stools (steatorrhea), a recent or current infection, or tuberculosis, or if you will be exposed to high temperatures for a prolonged period of time

if you have a heart valve replacement, an intrauterine device (IUD), or a catheter.

Some medicines may interact with Coumadin. Tell your health care provider if you are taking any other medicines, especially any of the following:

Heparin or other anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), salicylates (eg, aspirin), streptokinase, or urokinase because the risk of bleeding may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Coumadin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

Tell your doctor or dentist that you take Coumadin before you receive any medical or dental care, emergency care, or surgery.

Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Contact your doctor right away if you may have taken too much of Coumadin.

Do not drink alcohol while you are taking Coumadin; it may increase the risk of Coumadin's side effects.

Do not change you activity level or weight without checking with your doctor; the risk of Coumadin's side effects may be increased.

Do not change your eating habits without checking with your doctor. Eat a normal, balanced diet. Foods that have high levels of vitamin K (eg, green leafy vegetables, broccoli, liver, certain vegetable oils) may change the effect of Coumadin. Ask your doctor for a list of foods that may affect Coumadin. Tell your doctor if any foods on the list are a part of your diet.

Do not eat cranberry products or drink cranberry juice while you are taking Coumadin. Tell your doctor if these products are already part of your diet.

Elevated body temperature may increase the effect of Coumadin. Be careful to avoid becoming overheated, especially during hot weather.

Coumadin decreases blood clotting. Use caution while doing activities such as brushing your teeth, flossing, or shaving. Avoid activities that may cause bruising or injury. Seek immediate medical attention if you fall or injure yourself. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.

Do not take aspirin while you take Coumadin unless your doctor tells you to. If you already take aspirin for a heart or other condition, talk with your doctor about whether or not you should continue to take it with Coumadin.

Tell your doctor if you will be traveling or if you will be confined to a bed or chair for a long period of time (eg, car or airplane ride). This may increase your risk of developing a blood clot.

If therapy with Coumadin is stopped, the blood thinning effects may last for 2 to 5 days after you stop taking it. Discuss any questions or concerns with your doctor. Do not suddenly stop taking Coumadin without checking with your doctor.

Lab tests, including certain blood clotting tests (eg, PT, INR), may be performed while you use Coumadin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Coumadin with caution in Asian patients; they may be more sensitive to its effects, especially bleeding.

Use Coumadin with caution in the elderly; they may be more sensitive to its effects, especially bleeding.

Coumadin should be used with extreme caution in children; safety and effectiveness in children have not been confirmed. Children may need more frequent lab tests if they use Coumadin.

If you may become pregnant, you must use an effective form of birth control while you take Coumadin. If you have questions about effective birth control, talk with your doctor.

Pregnancy and breast-feeding: Do not use Coumadin if you are pregnant. It has been shown to cause harm to the fetus. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. It is not known if Coumadin is found in breast milk. If you are or will be breast-feeding while you use Coumadin, check with your doctor. Discuss any possible risks to your baby.

SIDE EFFECTS

All medicines may cause side effects, but many people have no, or minor, side effects.

No common side effects have been reported with Coumadin.

Seek medical attention right away if any of these severe side effects occur: